| NPI | 1124480926 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER J CARBO Co Owner 484-571-8919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: PA PC007162) |
| Additional Taxonomies | 251S00000X (Licence: PA CW 015583) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2016-03-22 |